Hallux limitus – what can be done with conservative care and inserts?

Hallux limitus (HL) describes the four stages of degenerative change that the great toe undergoes as the result of jamming or limited motion. Stage 1 HL has mild pain with no degenerative signs of change found on x-ray. Stage 4 on the other hand, also known as hallux rigidus, shows complete flattening and limited range of motion of the joint due to arthritis and bone spurs surrounding the joint. Stage 1 and stage 4 HL are two very different problems that need to be treated with different conservative approaches.

Can hallux limitus be treated without surgery?

In most cases, yes it can. Inserts can help to slow the progression of HL but won’t actually correct the existing problem. In most cases, arresting the progress of HL will significantly decrease pain in the joint.

There’s two fundamental ways to treat hallux limitus with inserts depending upon the stage of condition.

Hallux Limitus Stages 1 & 2

Prior to the onset of degenerative change seen in the joint on x-ray in stages 1 & 2 HL, increasing the range of motion can markedly decrease pain. A Vasyli-Dananberg Orthotic uses wedges to change the range of motion of the great toe joint. In the early stages of HL the wedges in the Vasyli-Dananberg Orthotic are used to increase the range of motion. As the joint progresses to stage 3, the position of the wedges can be changed to decrease the range of motion of the great toe joint. The Vasyli-Dananberg Orthotic is a well designed, innovative device specifically used to treat HL.

Hallux Limitus Stages 3 & 4

In HL stages 3 & 4, most folks are going to default to a rigid extension under the great toe joint called a Morton’s extension. The Turf Toe Plate is a classic design example of a Morton’s extension used to treat turf toe and hallux limitus. Most customers with stages 3 & 4 HL are quite surprised with the efficacy of the Turf Toe Plate. Funny looking insert but the perfect solution for end stage HL.

Which insert is the best choice for you? That depends on your stage of HL. Touch base with your doctor and get a set of plain x-rays taken. The discussion you have with your doc will help you to understand the best choice for your needs.